| NPI | 1790132926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 294494) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210203) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2018-04-18 |